Provider Demographics
NPI:1902987787
Name:HERSHEY, DOUGLAS WHITMER (MD)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:WHITMER
Last Name:HERSHEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 EXPOSITION BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95815-4300
Mailing Address - Country:US
Mailing Address - Phone:916-736-6888
Mailing Address - Fax:916-779-3260
Practice Address - Street 1:1111 EXPOSITION BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95815-4300
Practice Address - Country:US
Practice Address - Phone:916-736-6888
Practice Address - Fax:916-779-3260
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00G189620207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF06752Medicare UPIN